Computer-assisted surgical system

• US 5,682,886 A
• Filed: 12/26/1995
• Issued: 11/04/1997
• Est. Priority Date: 12/26/1995
• Status: Expired due to Term

• Current Assignee: CAST SPA, MusculoGraphics, Inc. (Motion Analysis Corp.)
• Original Assignee: CAST SPA
• Inventors: Robinson, Craig B., Delp, Scott L., Stulberg, S. David, Wong, Arthur Y., Loan, J. Peter
• Primary Examiner(s): Lateef, Marvin M.
• Assistant Examiner(s): MANTIS MERCADER, ELENI M
• Application Number:
  US08/578,497
• Time in Patent Office: 679 Days
• Field of Search: 128/898, 128/774, 128/653.1, 128/654, 128/920, 128/922, 128/924, 606/97, 606/99, 606/53, 606/60, 606/76, 606/96, 382/131, 382/132, 382/153, 382/285, 382/287, 382/289, 382/108, 382/190, 382/195, 382/203, 382/204, 364/413.13, 364/413.19, 364/413.14, 364/413.15, 364/522, 623/16, 623/20, 623/18, 623/22, 623/27, 623/36, 623/39, 623/66, 395/924, 395/123, 395/119, 395/120, 378/205
• US Class Current: 600/407
• CPC Class Codes: A61B 17/154 for preparing bone for knee prosthesis
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: G06T 19/20 Editing of 3D images, e.g. changing shapes or colours, aligning objects or positioning parts
• CPC Class Codes: G06T 2210/41 Medical
• CPC Class Codes: G06T 2219/2021 Shape modification
• CPC Class Codes: Y10S 128/92 Computer assisted medical diagnostics
• CPC Class Codes: Y10S 128/922 including image analysis

Abstract

A method for planning surgery on a body portion is provided in the steps of gathering image data, storing the image data, reading the image data into a computer, generating a three-dimensional computer model of the body portion from the image data, identifying anatomical features relevant to the surgery, and defining at least one desired correction to anatomical structures to be accomplished by the surgery. Also, a method for performing surgery on a body portion is provided in the steps of loading surgical plan data into a computer, registering a three-dimensional computer model of the body portion stored in the surgical plan data to the body portion, providing at least one surgical tool, positioning the surgical tool relative to the body portion and performing the surgery. Further, a jig assembly is provided in the form of a femoral docking jig, a femoral contouring jig, and a tibial jig.

Claims

1. A method for planning surgery on a portion of a body with the goals of improving the accuracy of the surgery and reducing the risks associated with surgery, comprising the steps of:

gathering image data of the portion of a body using a radiant energy means for gathering image data;

storing the image data in a memory means for storing image data;

reading the stored image data into a computer interfaced to the memory means, the computer having a visual display means for visually displaying images generated in at least one process step;

generating a three-dimensional computer model of the body portion from the image data using a modeling means for creating three-dimensional computer models from the image data;

identifying anatomical features relevant to the surgery on the three-dimensional computer model of the body portion; and

using software to define at least one desired correction to the anatomical structures to be accomplished by the surgery.

2. The method for planning surgery of claim 1, wherein the radiant energy means for gathering image data is selected from a group consisting of magnetic resonance imaging devices, X-ray devices, and computed tomography imaging devices.

3. The method for planning surgery of claim 1, wherein the memory means for storing image data is selected from a group consisting of electronic media, electronically erasable media, electromagnetic media, magnetic media, optical media, and magnetic-optical media.

4. The method for planning surgery of claim 1, wherein the visual display means is selected from a group consisting of raster display means and vector display means.

5. The method of planning surgery of claim 1, wherein the image data represent discrete areas corresponding to at least one relevant anatomical structure, wherein boundaries defining each anatomical structure are determined by predefined variations in the image data, and wherein the modeling means locates the boundaries that define the anatomical structures to create the three-dimensional computer model of the body portion.

6. The method for planning surgery of claim 5, wherein the modeling means locates the boundaries that define the surfaces of the anatomical structures and defines continuous curves corresponding to those boundaries to construct the three-dimensional computer model from those continuous curves.

7. The method of planning surgery of claim 6, wherein the modeling means uses a Canny filter to define a set of edges corresponding to the boundaries that define the surfaces of the anatomical structures.

8. The method for planning surgery of claim 7, wherein the modeling means uses a snake algorithm first to form active contours, and then to adjust the sizes and shapes of the active contours to fit the set of edges.

9. The method of planning surgery of claim 8, wherein the modeling means uses points on the active contours to create surface patches.

10. The method for planning surgery of claim 9, wherein the modeling means uses a third-order polynomial equation to define the surface patches.

11. The method for planning surgery of claim 10, wherein the surface patches are Bezier patches.

12. The method for planning surgery of claim 10, wherein the modeling means tessellates the surface patches into polygonal meshes that in combination correspond to the relevant anatomical structures.

13. The method for planning surgery of claim 1, wherein the modeling means is software.

14. The method for planning surgery of claim 1, wherein the modeling means identifies the relevant anatomical structures.

15. The method for planning surgery of claim 1, wherein the three-dimensional computer model of the body portion is displayed on the visual display means.

16. The method for planning surgery of claim 1, wherein software is used to define the desired corrections.

17. The method for planning surgery of claim 1, wherein the relevant anatomical features are displayed on the visual display means.

18. The method for planning surgery of claim 1, further comprising the step of determining the size and pose of at least one prosthesis to be used in the surgery.

19. The method for planning surgery of claim 18, wherein prothesis size data is stored in a second memory means accessible by the computer, and further comprising the step of determining prosthesis size and pose by comparing the three-dimensional computer model of the body portion with the prothesis size data.

20. The method for planning surgery of claim 19, wherein the prothesis size data includes at least two three-dimensional prosthesis images of different sizes.

21. The method for planning surgery of claim 20, wherein at least two three-dimensional prothesis images of different sizes are displayed on the visual display means, superimposed on the three-dimensional computer model of the body portion, and wherein a three-dimensional prosthesis image of a particular size is chosen to fit the three-dimensional computer model to a degree sufficient to accomplish the defined desired correction.

22. The method for planning surgery of claim 21, wherein at least two three-dimensional prothesis images of different sizes are displayed on the visual display means superimposed on the three-dimensional computer model, and wherein an operator chooses the size of the three-dimensional prosthesis image to fit the three-dimensional computer model of the body portion to a degree sufficient to accomplish the defined desired correction.

23. The method for planning surgery of claim 18, wherein the pose of the three-dimensional prosthesis image is adjusted to fit the three-dimensional computer model of the body portion to a degree sufficient to accomplish file defined desired correction.

24. The method for planning surgery of claim 23, wherein an operator adjusts the pose of the three-dimensional prosthesis image to fit the three-dimensional computer model of the body portion to a degree sufficient to accomplish the defined desired correction.

25. The method for planning surgery of claim 18, wherein the three-dimensional prothesis image is displayed on the visual display means superimposed on the three-dimensional computer model of the body portion, and wherein the size and pose of the three-dimensional prosthesis image are adjusted to fit the three-dimensional computer model to a degree sufficient to accomplish the defined desired correction.

26. The method for planning surgery of claim 25, wherein the three-dimensional prothesis image is displayed on the visual display means superimposed on the three-dimensional computer model of the body portion, and wherein an operator adjusts the size and pose of the three-dimensional prosthesis image of the prosthesis to fit the three-dimensional computer model to a degree sufficient to accomplish the defined desired correction.

27. The method for planning surgery of claim 18, further comprising the step of determining characteristics of at least one resection to be performed on the anatomical structures.

28. The method for planning surgery of claim 27, wherein the resection is shown in relation to the three-dimensional computer model and displayed on the visual display means.

29. A method for planning unicompartmental knee arthroplasty surgery with the goals of improving the accuracy of the surgery and reducing the risks associated with surgery, comprising the steps of:

gathering image data of a femur and a tibia using a radiant energy means for gathering image data;

storing the image data of the femur and tibia in a memory means for storing image data;

reading the stored image data into a computer interfaced to the memory means, the computer having a visual display means for visually displaying images generated in at least one process step;

generating a three-dimensional computer model of the femur and tibia using a modeling means for constructing three-dimensional computer models from the image data;

identifying a hip center on the three-dimensional computer model;

identifying a knee center on the three-dimensional computer model;

identifying an ankle center on the three-dimensional computer model;

defining the line from the hip;

center to the knee center on the three-dimensional computer model;

defining the line from the knee center to the ankle center on the three-dimensional computer model;

determining a desired varus/valgus correction on the three-dimensional computer model;

determining the size and pose of both a femoral prosthetic component and a tibial prosthetic component to accomplish the desired correction on the three-dimensional computer model; and

,

determining the size and pose characteristics of resections to be performed on the femur and the tibia as shown in the computer model.

30. The method for planning surgery of claim 29, wherein the radiant energy means for gathering image data is selected from a group consisting of magnetic resonance imaging devices, X-ray devices, and computed tomography imaging devices.

31. The method for planning surgery of claim 29, wherein the memory means for storing image data is selected from a group consisting of electronic media, electronically erasable media, electromagnetic media, magnetic media, optical media, and magnetic-optical media.

32. The method for planning surgery of claim 29, wherein the visual display means is selected from a group consisting of raster display means and vector display means.

33. The method of planning surgery of claim 29, wherein the image data represents discrete areas corresponding to each of the femur and tibia;

wherein boundaries that define surfaces of each of the femur and tibia are determined by predefined variations in the image data; and

, wherein the modeling means locates the boundaries that define each of the femur and tibia to create the three-dimensional computer model.

34. The method for planning surgery of claim 32, wherein the modeling means locates the boundaries that define the surfaces of each of the femur and tibia, and defines continuous curves corresponding to those boundaries to construct the three-dimensional computer model from those continuous curves.

35. The method for planning surgery of claim 33, wherein the modeling uses a Canny filter to define a set of edges corresponding to the boundaries that define the surfaces of each of the femur and tibia.

36. The method for planning surgery of claim 35, wherein the modeling means uses a snake algorithm first to form active contours, and then to adjust the sizes and shapes of the active contours to fit the set of edges.

37. The method for planning surgery of claim 36, wherein the modeling means uses points on the active contours to create surface patches.

38. The method for planning a surgery of claim 37, wherein the modeling means uses a third-order polynomial equation to define the surface patches.

39. The method for planning a surgery of claim 38, wherein the surface patches are Bezier patches.

40. The method for planning a surgery of claim 38, wherein the modeling means tessellates the surface patches into polygonal meshes that in combination correspond to surfaces of the femur and tibia.

41. The method for planning a surgery of claim 29, wherein the modeling means is software.

42. The method for planning a surgery of claim 29, wherein the image data of a femur includes data relating to a femoral head having a perimeter, and wherein the step of identifying the hip center comprises identifying at least four points on the perimeter of the femoral head on the image data, defining a sphere from these four points, and defining the center of the sphere as the hip center.

43. The method for planning a surgery of claim 42, wherein the four points, the computer image of the sphere, and the image data of the femoral head are displayed on the visual display means.

44. The method for planning a surgery of claim 42, wherein the four points are automatically identified by software programmed to find the four points.

45. The method for planning a surgery of claim 29, wherein the step of identifying a knee center comprises the steps of identifying epicondyle points on each of a femoral lateral epicondyle and a femoral medial epicondyle, defining a line segment connecting the epicondyle points, and defining the midpoint of that line segment as the knee center.

46. The method for planning a surgery of claim 29, wherein the step of identifying an ankle center comprises the steps of identifying malleoli points on each of a medial malleoli and a lateral malleoli on the three-dimensional computer model, defining a line segment connecting the malleoli points, and defining the midpoint of that line segment as the ankle center.

47. The method of planning surgery of claim 29, wherein the hip center, knee center, ankle center are displayed on the visual display means.

48. The method for planning surgery of claim 47, wherein the lines from the hip center to the knee center, and from the knee center to the ankle center, are displayed on the visual display means.

49. The method for planning surgery of claim 45, further comprising the steps (a) identifying on the three-dimensional computer model the femoral condyle on which the arthroplasty is to be performed;

(b) translating the knee center to the origin of a Cartesian coordinate system;

(c) rotating the three-dimensional computer model until the hip center lies on a coordinate axis;

(d) rotating the three-dimensional computer model about the selected coordinate axis until the plane formed by the hip center and the epicondyle points is parallel to a coordinate plane formed using the selected coordinate axis, so that the line from the hip center to the knee center is aligned with the selected coordinate axis;

(e) selecting a vertex on the three-dimensional computer model of the opposite femoral condyle that has the lowest value along the selected coordinate axis;

(f) defining a rotation axis as the line perpendicular to the selected coordinate plane through the selected point; and

, (g) rotating the three-dimensional computer model of the tibia about the rotation axis until the alignment has been accomplished.

50. The method of planning surgery of claim 49, wherein the selected point, the rotation axis, and the varus/valgus correction are identified by software stored in the computer.

51. The method for planning surgery of claim 29, wherein size and three-dimensional image data for each of the femoral and tibial prosthetic components is stored in a second memory means accessible by the computer, and further comprising the step of determining the size and pose of the prosthesis components by comparing the three-dimensional computer model of the femur and tibia with the prothesis size and image data.

52. The method for planning surgery of claim 51, wherein the three-dimensional prothesis image data is displayed on the visual display means superimposed on the three-dimensional computer model of the femur and tibia, and wherein the size and pose of the three-dimensional prosthesis image are adjusted to fit the three-dimensional computer model to a degree sufficient to accomplish the defined desired varus/valgus correction.

53. The method for planning surgery of claim 52, wherein at least two three-dimensional images of different sizes of the femoral prosthetic component and the tibial prosthetic component are displayed on the visual display means superimposed on the three-dimensional computer model of the femur and the tibia, and wherein a three-dimensional image of the femoral prosthetic component of a particular size, and a three-dimensional image of the tibial prosthetic component of a particular size, are chosen to fit the three-dimensional computer model to a degree sufficient to accomplish the defined desired varus/valgus correction.

54. The method for planning surgery of claim 53, wherein at least two three-dimensional images of different sizes of the femoral prosthetic component and the tibial prosthetic component are displayed on the visual display means superimposed on the three-dimensional computer model of the femur and the tibia, and wherein an operator chooses a three-dimensional image of the femoral prosthetic component of a particular size, and a three-dimensional image of the tibial prosthetic component of a particular size, to fit the three-dimensional computer model to a degree sufficient to accomplish the defined desired varus/valgus correction.

55. The method for planning surgery of claim 29, wherein the resections of each of the femur and tibia are shown in relation to the three-dimensional computer model of the femur and tibia and displayed on the visual display means.